This document discusses whiplash, which refers to injuries to the neck caused by sudden acceleration-deceleration movements like those in car accidents. It begins by outlining the history and terminology of whiplash. The mechanism of injury involves cervical acceleration and deceleration, stretching and tearing muscles and tendons. Common causes are car accidents and falls. Injuries can range from muscle strains to fractures. Symptoms include neck pain and stiffness. Treatment involves immobilization, medications, physical therapy, and sometimes surgery for severe cases. Most patients see gradual improvement over 3 months to a year.

1. Dr. Santosh Batajoo
Orthopedic

2. introduction
 Harold Crowe in 1928, first used term to
describe movement of neck in accident.
 First coined as railroad spine in 1919 following
train collisions.
 Also known as sprained neck, neck strain,
acceleration injury, soft tissue neck.
 Occupant’s body is forced against the car seat
while his or her head flips backwards and then
recoils in flexion.

4. mechanism
 Cervical acceleration and deceleration.
 Any impact or blow that causes your
head to jerk forward or backward.
 The sudden force stretches and tears
the muscles and tendons.

5. causes
 Motor vehicle accidents (common)
 Head banging
 Falls
 Sports injury
 Shaken baby syndrome

7.  After impact, the cervical spine
undergoes S-shaped curve. The lower
part into extension and the upper part
into flexion.
 The lower part of the cervical spine
moves beyond its normal range.
 Whip like movement.

8. pathology
 Anterior longitudinal ligament of the
spine and the capsular fibres of the facet
joints are strained and intervertebral disc
may be damaged.

9. Grading (WAD)
grade Clinical pattern
0 No neck symptoms or signs.
1 Neck pain, stiffness and tenderness.
No physical sign.
2 Neck symptoms and musculoskeletal signs.
3 Neck symptoms and neurological signs.
4 Neck symptoms and fracture and dislocation.

10. Possible injuries
 Joint dysfunction
 Disc herniation
 Facet joint cartilage damage
 Disc tear
 Nerve root impingement
 Muscle tear
 Ligament tear

11.  Medullary overstretch
 Dura overstretch
 Dislocation
 Fracture
 Spinal cord injury
 Brain injury (coup-contra-coup)

12. Clinical features
 Often the victim is unaware immediately.
 Pain and stiffness of the neck.
 Neck muscles are tender.
 Skew neck.
 Temporomandibular discomfort
 neurological : headache, dizziness,
blurring of vision, paraesthesia in the
arms, tinnitus.

13.  Psychological-
memory loss, cognitive impairment,
sleep disturbance, fatigue, depression,
PTSD.

14. Differential diagnosis
 Vertebral fracture
 Acute disc lesion
 Seat-belt injuries

15. investigations
X-ray
 Straightening out of the cervical lordosis.
MRI
CT scan

16. treatment
 Must be immobilized as soon as
possible.
 Collars
 Analgesic, muscle relaxants.
 Ice then moist heat after 2-3 days.
 Postural adjustments.
 Isometric muscle contractions.
 Others - Ultrasound, Traction, massage

17.  Injection – local anaesthetic, steroid,
botulinum toxin A
 prevention - top of the head restraint as
high as the top of the head, and as close
to the rear of your head as possible.

18.  Severe case may require surgery.

19. progress
 Some patients start improving within a few
weeks and in most patients symptoms
diminish gradually after about 3 months and
go on improving over the next year.
 Negative prognostic indicators are-
increasing age, severity of symptoms at the
onset, prolonged duration of symptoms, pre-
existing intervertebral disc degeneration,
psychological dysfunction.

20. THANK YOU